The painful incident came at the end of a ceremony where Ed Sheeran and Sam Smith shared the honours, winning two awards each.

An average of 5.3 million people tuned in to the ceremony on ITV, according to overnight ratings – rising to 5.8 million when ITV+1 viewers are added in.

That is up from the 4.6 million who tuned in last year – but less than 2013’s overnight audience of 6.5 million.

At the scene

John Hand, BBC News
Well, sitting way up in the balcony seats among some of Madonna’s biggest fans – the type who know and sing along with every lyric – the initial thought was that it may have been a particularly well orchestrated dance manoeuvre.You may have wondered why there was no gasp of shock from the O2 crowd as Madonna took her backward tumble.

Consider the evidence – she fell on the lyric “I let down my guard, I fell into your arms” and was back on her feet to sing purposely “now that it’s over, I’m going to carry on”.

The truth later emerged but credit to the showbiz trooper for carrying on. In the words of those other Brit Award history-makers Chumbawamba “I get knocked down but I get up again”.

Sheeran scooped the night’s main prize, album of the year, for his record X – which was the best-selling record of 2014 in the UK.

“I was really worried abut this album,” he said, accepting his trophy from actor Russell Crowe. “It took a long time to make.”

The star added it had been a “very, very good year for British music”.